DENTAL
What date does dental plans end on?
All plans end on Dec 31st
T or F: Disenrollment, cancellation, and terminations are all considered the same?
True
What 3 types of difficult customers?
Unhappy
irritated
abusive
What is a binder payment
Very first payment to effectuate a new plan
What are the 4 types of forms
ARD, PSI, NDF, CDF
What are the dental carriers the HealthConnector has?
Altus Dental and Delta Dental
How can a member cancel their healthconnector coverage?
Phone or online/member portal
Why do customers get angry?
Time
Confusion
Concerns
Worry
What are the ways you can pay your initial binder payment
Online, mail, IVR
Who can make changes to the account?
ARD/NDF
What is the set amount that MUST be paid before insurer will pay for dental services
Deductible
HOH reports a Health connector plan enrollment subscriber is deceased and there are surviving dependents who still need coverage what steps would you take
Edit application report and change click remove someone from application select Death from the drop down and update the entire application
What is the anger cycle
questions, Back talk, Refusal, Challenge, Outburst, Quiet Period and in control
How many missed payments before your account becomes delinquent
2
Form 8962 is used to claim the correct amount of what?
Premium tax credit to ensure the right amount of APTC
How many dental carriers and dental plans are available
If a member is deceased but has surviving members on their account what will be the end date of the coverage?
Date of Death
How do you handle self Harm or Threats?
Stay calm, reassure the caller that you care and want to help , Listen without Judgment and demonstrate ownership and acknowledge what is here
T or F: You can make binder pmt on IVR system
False
A subsidized member would need what form in order to use their 1095A?
8962
Is the Redetermination and Renewal Process for both health plans and dental plans the same what are the steps of redetermination?
yes health connector accesses the Federal Data Hub, Accesses information about the member and uses information from the HUB to determine the plans
The household is enrolled in health and dental both in HIX and only wants to cancel dental coverage what are your actions
go into HIX select retro enrollment choose dental/health plan year and the subscriber change the end date for the LAST day of the month
Steps for managing anger
Think before you speak, talk to someone and express your anger, get some exercise, take a timeout, identify possible solutions, remember the big picture, don't hold a grudge, use humor to release tension, Practice relaxation skills, know when to seek help
Why would an enrollee stay in Awaiting status when making their Binder payment
to be allowed one more month to pay the account balance
What is a grace period used for?
the last month of enrollment when a member was enrolled in subsidized coverage and did not pay their premium.